Provider Demographics
NPI:1396839585
Name:EHS MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:EHS MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURANCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-473-7731
Mailing Address - Street 1:PO BOX 2255
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2255
Mailing Address - Country:US
Mailing Address - Phone:509-473-7932
Mailing Address - Fax:509-473-3057
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:SUITE 422
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-473-3077
Practice Address - Fax:509-473-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000439542084N0400X
WAMD000160402084P0800X
WAMD000326152086S0129X
WAMD00020071208VP0000X
WAPA10003902363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7129117Medicaid
WA7129166Medicaid
WA7129117Medicaid